Monday, August 31, 2009

Still in the Hospital

Dee Dee is still in the hospital, but doing fine. The sedatives they gave her in the ambulance took a while to wear off, but as of last night she was walking around and chatting normally. She no longer has back pain, which tells me it was mostly just pain from not being situated in the hospital bed correctly.

The reason she's still in the hospital is because the doctor wants her to have some more physical and occupational therapy, and he also wants to get a psychological evaluation. I think the psychiatrist was there with her as of this morning - we'll know more soon. I was hoping to have her back with us yesterday, but it was not to be.

I'll be visiting her later on today to check on her, but I'm starting to hear murmurs about her not coming back to our house when she's released. I haven't spoken to any doctors or to Ace/Diane yet, but I think there may be concern that unless the mental issues get better, our house isn't the best place for her.

I have high hopes that if the increase in dementia was caused by the urinary tract infection, she will become more coherent over the next few days. I would also add that I don't think her having more dementia affects her staying here per se. If she wants to talk to me all day about how she got married at age 15 and has parties at night with her brothers and sisters, that's fine by me.

But I also see that if the mental issues cause her to crawl around on the floor and zonk out for hours in our foyer, that's probably not the best situation.

So we'll see how things develop. As always, I'll keep the blog updated.

Saturday, August 29, 2009

To the Hospital

Michele and I just got back from Missouri Baptist hospital, where Dee Dee is spending the night. Diane was with her when we left, and Ace is probably heading there at some point, too.

(By the way, Ace took her to the doctor on Friday and did indeed find that Dee Dee had a urinary tract infection. So Roxana was correct in that guess. We started her on antibiotics last night, and in fact she seemed not at all combative or agitated last night.)

Dee Dee is mostly fine. She's pretty alert. X-rays and MRI (or maybe CT scan?) came back negative. She's complaining about back pain and won't/can't walk. If she had walked for the doctors tonight, they would have sent her home with us, in fact.

We were hanging out at home today while my mom and dad took the girls to the movies. I was getting ready to take Dee Dee to White Castle when I find her on the floor in her room, sitting up. She's scooting across the floor. I rush over to her and offer to help her up. She strongly discouraged me from helping her up and said she just wanted to rest.

Alright - I can't help someone up who wants to stay on the floor. But instead of resting, she scooted into the hallway and then laid down for a few seconds, then sat up and scooted more, then laid down, etc. All the while she just told me she was fine - she just needed to rest.

She eventually scooted to the front foyer on the hard-wood floor and laid down on her back, eyes closed. It really looked like she was asleep. Her breathing and pulse were normal. But we couldn't wake her up for anything. Michele was yelling into her good ear and got no response.

When we tried to help her up, she strongly resisted. Her eyes were closed and she wasn't talking, but she definitely wanted to stay right where she was. It was the strangest thing. Whenever we tried to cover her up or hold her hand, she strongly waved or kicked us away.

Eventually, after consulting Ace and Diane and the on-call doctor, we called 911. They whisked her away. As they lifted her into the ambulance, she was yelling at the EMS guys to leave her there. All still with her eyes closed.

Once in the ER, Michele tells me they had a normal conversation. She was a little groggy from the sedative the EMS guys gave her (to get her to calm down enough for an I.V.) but otherwise seemed normal. They ran a bunch of tests over the next few hours, but they all came back negative.

She's complaining of back pain. At one point she said that she hurt her back falling out of her chair in her bedroom. But then later she said her back was fine until she had to lay so long in the hospital bed. So who knows. Nothing's broken, though.

The next step is to get her to walk. Michele and I are worried that once she's checked into the hospital, there might be a slow recovery. That's what happened in February when she went to the hospital for a bowel impaction and then got dehydrated and wound up having to spend weeks in a nursing home.

We'll keep the blog updated as we learn more.

Friday, August 28, 2009

"The Party's Over"

Michele here. I haven't posted in quite a while - since it stopped being fun to talk about how Dee Dee was doing. As Brian has been documenting, she has been growing progressively worse.

Brian did a great job of recapping last night's excitement, but I have a few details to add. Dee Dee was urgent to get out of the house last night for the family party to which I was not invited. After our little walk in the rain around 2 am (Dee Dee fully dressed but without a sweater or jacket, and me in my nightgown and bare feet), I coaxed Dee Dee into pajamas and persuaded her (I thought) that the party was postponed until tomorrow because of the rain outside. Ten minutes later, she was fully dressed again and headed for the door. She spent a full hour circling the house from one door to the next, trying each one and moving on. I might have considered going back to bed, but she consistently parked her walker and kept trying to leave without it. (This morning she explained to me that there were no walkers allowed at the party.) So I busied myself in the family room and kitchen - making lunches, folding laundry, cleaning out the fridge - so that I could keep an eye on her.

Eventually, she got tired and went to bed, around 4:30. I set myself up on the couch for the night, to be sure I heard her if she got up again. Which she did, at 5:30. She insisted that I come stand in her room and listen to everything she had to say. I cut her off after a couple minutes, telling her I had to sleep. She became extremely agitated by this, demanding that I listen to her. When I asked her if her story was related to the party, she gave me a puzzled look, and replied, "No, the party's over."

I left her room sooner than she wanted and returned to the couch. Over the next hour, she filled an entire notepad with notes about the special telegrams she needed to send to all of her family all over the world (relatives in Norway, Ireland, and Europe, which, to my knowledge, do not exist).

All morning she has been very anxious and demanding of my time. She keeps pulling me into a room where we can talk privately - away from Louisa's ears - and the things she is saying, I have to admit, make no sense. One sentence doesn't follow coherently from another, but each time I interrupt to ask a question, she accuses me of not believing her.

Needless to say, five days away is too long to wait to see the doctor. My mom is calling this morning to see if we can get in earlier.

The woman living in my house bears little to no resemblance to the grandma I remember. She is becoming increasingly self-consumed, demanding, and accusatory. It is so hard to believe when you know the incredibly sweet and selfless woman she has always been. I am praying that the doctor will have medications to deal with these new delusional symptoms. We need a big improvement, quickly, for her to be able to stay here with us.

As for me, my aunt is coming for a visit today, and I am planning a nap for the three hours that Louisa is at kindergarten.

Night Dreams

I'm not entirely sure what's going on, since it's 3:30 in the morning. Michele could tell you better than I could. I don't think either of us will be going back to sleep at this point.

Dee Dee has been up and about for a few hours now. That's not so surprising on its own - she often is just as awake at night as she is during the day. I suppose that makes sense when you take lots of naps and don't know whether it's day or night.

Tonight, though, Michele and I noticed a sound by the front door around 11:00 pm. Michele investigated, and to our disappointment it was Dee Dee trying to walk out the front door. At night. In the rain. On a strange street. Near a busy highway. Without her walker. However, I will give Dee Dee points for being fully dressed and wearing some good walking shoes.

Thankfully, we've got those child-proof doorknob thingies that prevent most people (even most adults, it seems!) from opening them. We've got them on all three doors on the main level. That was a precaution we took early on just in case.

Michele was then up a few times over the next few hours to help guide Dee Dee as she wandered around the house. For extra excitement, she's been trying to do most of this walking without her walker. Yikes! She fell down on our watch that very first night she spent with us and not at all since then. Dee Dee, don't ruin our record! :)

I'm not sure when Michele gave up on sleep, but I gave up around 3:00. I came out to the family room to see what Michele had been dealing with: Dee Dee walking from door to door, trying to walk out, then saying "Oh right, this one is locked." I asked her if I could help her, and she just said "Oh good morning, Brian! No, I'm just dreaming," and walked on to continue trying the doors. She seemed pretty cheerful to me.

As Michele tells me, around 2:00 this morning, in an effort to humor Dee Dee and calm her down, she offered to go outside with Dee Dee. They walked together in the rain. Dee Dee said she was going to a party with her brothers and sisters because one of her daughters just died, and Michele wasn't invited. When Dee Dee got to Highway 141 and started to cross it, Michele brought her back to our house.

We've got a doctor's appointment for Dee Dee this coming Wednesday. Five days away. I think it's reasonable to say that if we can't get her to sleep through the night, we'll have no choice but to bring her back to the nursing home.

Tuesday, August 25, 2009

Friends and Family

In the past week, Michele and I have been swarmed with calls, emails, and offers of help. Thanks so much to all of you. Michele got some flowers from Sarah and an offer of Dee-Dee-sitting from Juli. Lynda has offerred to come up from Texas to help out, and tonight Maggi is bringing us some dinner. Wow! I know I’m forgetting some folks – we appreciate and thank all of you.

Add to that all the normal, everyday help from Denise and Diane, and we feel pretty lucky. Even when things have been tough like they've been the last couple weeks.

Especially touching to me personally has been the offers of help from friends of our in Jefferson City. A lot of those friends have been following the blog, and some were notified by a prayer chain request Michele sent to our old church. Michele's had some great talks with Julie and Stephanie and probably some others.

Last night, I had a great talk with another old JC friend, Jana. Her cousin, Roxana, is some kind of geriatric specialist (Jana – what is her title again?) and had some great advice for us.

One of the pieces of advice I thought was especially intriguing. Roxana said that in cases where there is a sudden and rapid increase in dementia, it’s usually (75% of the time) related to a bladder infection. Especially among women. She said this was especially important for us to know because most primary care doctors don’t know to look for that.

It reminded me that perhaps we’d be better served by seeing a geriatric specialist instead of Dee Dee’s long-time doctor. I don’t know. If anyone has any experience with doctors specializing in geriatric medicine, please let us know!

Friday, August 21, 2009

Dreams

"Have you ever had a dream that seemed so real that you just can't shake it?"

That's what Dee Dee has asked me several times in the last couple days. We just went out for some White Castle, just Michele, Dee Dee, and me. It was a good time. Since it was over my lunch hour, we drove separately, although I was able to swing it so that I drove with Dee Dee alone there.

I'd been thinking for a while about if/how to bring up the "I'm Dead" topic. I broached it today in the car. I decided I would avoid trying to convince her that she's not dead and instead just focus on how much she loves Michele, and it makes Michele sad when people talk about death with her.

So that was my plan. I executed it somewhat okay, but she threw me for a curve by implying that she doesn't really believe she's dead lately but that she's had really realistic dreams.

In short, I think the outing to White Castle went well. Michele's taking her shopping right now, and we know that at least in part, keeping Dee Dee busy is helpful in tamping down those delusions.

On Death and Dying, Part 2

Physically, Dee Dee seems to be doing great. We've got a new home health person (we politely fired the last one and her agency) named Jennifer, and she got on Dee Dee's good side by giving her two massages.

Mentally, things are a different story. Dee Dee has latched on to the idea that she's dead. But at the same time, she knows she's alive. She doesn't seem to have a problem with the logical inconsistencies.

While listening to a podcast of RadioLab (which I highly recommend), they had a segment on Cotard's Syndrome. You can listen to it here - just go to part 6, around the 5:00 mark of the 2nd segment. Basically, it's a mental illness where the patient believes that they are dead. Reading up on it in Wikipedia, one of the first diagnoses of this disease went hand-in-hand with not eating, which Dee Dee did for a while Wednesday. She told Michele she didn't need to eat "because of what we talked about earlier."

Those who know Dee Dee lately knows that she loves to eat. I wouldn't have thought she could go 4 hours without eating. But she went almost 24 hours the other day.

Anyway, I'm not a doctor and I have no idea if this is what she suffers from. But I personally find it helpful to look at her thoughts as the effects of a disease rather than ... I don't know. To me, it seems similar to when your three-year-old might say "I hate you, Daddy!" You're not going to lose sleep over it. It's a passing thought that they sincerely hold, but it doesn't reflect their true self. If you decide to argue with the three-year-old, you'll be sorely disappointed. They don't hold to ideas of logic or reason.

It's fair to say that Michele is struggling pretty hard with these death delusions. I think we were pretty prepared for her forgetfulness and her physical impairments. But the delusions have caught us off guard.

We're getting her to see a doctor soon. The hope is that he can either convince that as a medical expert, she can believe him when he says she's not dead. Otherwise, he could refer us to a psychiatrist or something.

Basically, we don't know how to talk to her. Do we contradict her? Convince her she's alive? Or can Dee Dee happily live another decade believing she's dead? Or is it a passing fancy that we shouldn't worry about?

Right now, Dee Dee treats Michele as her confidante. That's a good thing. But I'm thinking it might be helpful for some other folks Dee Dee knows and loves to also talk to her about these thoughts.

Tuesday, August 18, 2009

On Death and Dying

Dee Dee had a rough birthday this year. On Sunday, she turned 89. As always, she was surrounded by loving relatives. Dave and Billye flew in from California, and Lisa and the boys came in from Chicago. She got the traditional singing and sirens at Happy Joe's Pizzeria.

But all was not well with her soul. A few nights ago (Friday night), she started writing notes like crazy. She was especially restless. In the morning, she told Michele that she had a premonition from God that she was going to die the next night. She spent a lot of the day crying Saturday.

Michele and Diane took her out to lunch that day at Lion's Choice. While they were eating, an ambulance drove by, but Dee Dee didn't comment on it.

Later, when they got home, Dee Dee mentioned "Did you see what happened at Lion's Choice?"

"What was that, Dee Dee?"

"That ambulance? It stopped and picked me up. I'm dead."

"I didn't see that part, Dee Dee."

"Yeah, well, it happened in a split second."

Dee Dee could not be convinced that she wasn't dead. Only hours later, after she'd had dinner with a bunch of kids and grandkids and great-grandkids, did she acknowledge that maybe she isn't dead.

Michele had a talk with Dee Dee that night, prompted by Dee Dee's concerns about how she was raised in the Catholic church, and if you ever go to another church, even just to visit, you're kicked out of the Catholic church. Michele had a good opportunity to share the basic gospel message with Dee Dee, which apparently greatly relieved her. Michele's not sure how much sunk in, but Dee Dee thought it was literally "good news!"

Still, Michele and I slept a little lighter than normal that night. Isn't that how all the stories you hear turn out? The crazy person says something is going to happen, nobody believes them, and then it turns out to be true?

She seemed pretty good for a couple days, although she still cried a couple times. She told us, "Well, when you're turning 90, it's pretty emotional." (She's continually disappointed when we remind her that she's only 89)

Last night, around 12:30 a.m., Michele found Dee Dee in the kitchen, writing again. The note read something like "I didn't want to spoil anyone's night or wake anyone up, but I'm going to die peacefully in my sleep tonight." She'd apparently had another premonition.

So that's where we are today. In a lot of ways, talking about death can be healthy. Part of our consternation about all this death-talk is just our own fear of Dee Dee dying. I know she's going to die someday, but I don't want her to talk about it.

But it's still disturbing to see her so delusional, to confuse death with being alive, to get premonitions from God, to imagine ambulance rides that never happened.

And of course, it's tough to watch Dee Dee be so sad.

Some of you have heard me comment that my goal in this family is to keep the kids laughing, and to keep Michele from crying. Now I'm amending it to "... and keep Michele and Dee Dee from crying."

Monday, August 10, 2009

I've got to get to the Lake to see my family

The family headed down to the Lake of the Ozarks, with Dee Dee, to hang out with Michele's sister and her two boys. It went great. Dee Dee had lots of people on hand to help her, and I think it's good for her any time we get her out of the house.

On Friday, we brought Dee Dee back from the Lake. She took a nap in the car and then when she got home. This turned out to be important, as in her mind, she was just with us at the Lake.

At 1:00, we got our new home health person, Yolanda. We had the standard meet and greet that we've become accustomed to. After Dee Dee was settled and looked good to go, the rest of us headed out the door for some family time at the mall.

While we were gone, apparently, Dee Dee tried to leave the house repeatedly. Since there are several doors on the main level that she has rarely seen used, this meant that she was trying the door to the garage, the front door, and the door to the basement (the most dangerous door of all for her). Yolanda of course prevented her from leaving, at one point even standing in front of Dee Dee.

Dee Dee asked for Yolanda's phone at another point, saying that she needed to call us.

So it didn't go well. We got the after-action report from Yolanda, then later we heard Dee Dee's side of the story. You see, that woman was keeping Dee Dee from going to the Lake to see her family. We had left without her. Yolanda was mean. She wouldn't even let Dee Dee use her phone to call 911. She wouldn't let Dee Dee leave the house to find us.

"But Dee Dee, we weren't at the Lake. We told you we were just running some errands."

"But I told her I needed to go to the Lake to see my family, and she wouldn't let me!"

"Dee Dee, we told you, we weren't at the Lake."

"But she didn't know that."

Dee Dee was obviously very confused, and it was the most agitated I'd ever seen her. She definitely believed that we drove to the Lake while Yolanda was there. But even after she recognized that we were just out running errands, she was still upset that Yolanda wouldn't believe anything Dee Dee said. I've never known Dee Dee to dislike anyone, but she definitely disliked Yolanda.

We had high hopes before that visit that Dee Dee would adjust well to her new home health helper, but Friday was not a good start.

Monday, August 3, 2009

Home Health Care Problems

The biggest help for us, and the only reason taking care of Dee Dee is at all possible, is the home health care helpers. Michele, is that what we call them? They bathe Dee Dee, hang out with her, do some physical therapy exercises, some light cleaning, etc. We went with a company called Home Instead.

Our hope was that we could bring someone in who could become a real friend to Dee Dee. Someone long-term. Someone that Dee Dee would look forward to seeing three times a week.

Our hopes were answered with Fozia. Sweet, mild-mannered, and just a hint of an African accent. Dee Dee fell in love with her. "When is Fozia coming back? I like her!"

Then after about two weeks, she didn't show up at her house at the appointed time. We called the agency and they tried to contact her to no avail. I still don't think we know what happened there, but I understand she's no longer employed by Home Instead.

We were worried about telling Dee Dee about Fozia not coming back. But when we broke the news to her, she just said something to the effect of "She didn't show up? Well, that's no way to run a business!"

The next caregiver, Annikki (from Sweden - man, I love those accents!) lasted a couple weeks as well. But she didn't show up last night. So that means our caregivers have lasted about two weeks each. Needless to say, we're frustrated. Do we stay with Home Instead, look for another agency, or what? Or is this such a high-turnover industry that we can't expect to have one person for years at a time?

Saturday, August 1, 2009

White Castle's Been Around a Long Time

White Castle has always been a favorite of Dee Dee's. Michele didn't feel like heading out today, and I get cabin fever easily, so I took Dee Dee and the girls out and left Michele home. Dee Dee raised the average female age at the table from 7 to 27.

In our discussion there, she mentions that White Castle has been around a long time, and that she doesn't remember a time when there wasn't a White Castle.

The first White Castle opened in 1921. Dee Dee was born in 1920. So that makes sense. I don't want to give the impression that everything she says is off-the-wall; much of what she has to say is accurate and/or insightful. But I just had to look up White Castle on Wikipedia just to double-check her recollection.

During lunch, she also talked a lot about how our girls are growing up, and boys are going to start checking them out. "You'll be out at a dance or a show [in her mind, these are what kids do on weekends] and two guys will walk by your girls, then they'll turn around and say 'Man, there goes a looker!'" After pausing to reflect, she then added "And boys don't always stop doing that even after they're married!"

Anyway, it was fun, and it felt surprisingly normal. We all ran back to the car in the rain, which has got to be the first time in years that Dee Dee has had to run in the rain.

Michele took a trip to Grant's Farm yesterday with Dee Dee and some members of Michele's Aunt's family (Ace, Ashley, Henry). We'll try to get some picture up soon of that trip.